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Abstract
The acts of terrorism can be initiated in one country and take effect in another place. Preparations to counter such attacks require the combined efforts between the private and the public health sector. In order to be fully prepared, different state agencies should work together. A collective approach towards enhancing preparedness is likely to succeed.
This paper shall assess the level of interconnectedness of different government wings and how they depend on each other to execute the preparation strategies. In elucidating this, the paper shall seek to uncover whether local health responders have made any plans that seek to address bioterrorism. The paper shall also look at the responders who are involved in cases of bioterrorism and how they work together. Lastly, the paper shall attempt to point out any shortcomings in the manner of operation between these different wings and suggest how the shortcomings can be dealt with. In this research, different units of the CDCs shall also be considered and the manner in which they seek to achieve the target intention. The research shall also delve into how preparedness is beneficial.
Introduction
In 2001, there was an outbreak of the anthrax in the United States. This was a blessing in disguise as it exposed the lack of proper preparedness for such attacks. The anthrax spores are said to have been mailed in America (Henderson et al, 2003). This led to an outbreak of the disease throughout the nation. The response that was staged to manage the outbreak faced some challenges. In order to avert such attacks new strategies have been put in place to ensure that there is a quick detection of any attack and also a quick dissemination of the vaccine and treatment in case of any attack. This research shall delve into how efficient these strategies are in combating attacks.
The level of preparedness normally determines the number of lives that would be saved and also how fast the nation will recover from the attack. The main question in this research is whether the current health programs are efficiently prepared for bioterrorism. The research supposes that the concept of preparedness cannot be fully covered. This issue stems from the fact that the acts of terrorism are not completely foreseeable.
The stability of a country is very important for its economic as well as economic growth. For this to be achieved, there must adequate security (Grais et al., 2003). Security is important for any country. Security, as a concept, is very broad and includes economic as well as political sense. Every country has strategies to ensure that it has a security that covers its territory as well as its interests. Strategies form the level of preparedness for any country. The military is part of the strategy that determines how a country prepares to avert any adverse offence from an enemy country. Terrorism has been growing in the country.
Terrorism is a security challenge for many nations. While many believe that terrorism is normally accompanied with explosives, there is another form of it which is characterized by the use of science and specifically biochemical. Bioterrorism poses a challenge as it is difficult to detect its presence (Henderson et al., 2003). Bioterrorism is not a novel challenge in the United States and the world generally. It has been there since time immemorial and the need to shield from it cannot be underestimated.
Basic Elements Involved in the United States Health Preparedness
The elements involved in preparedness take different strategies (Treat, 2001). However, there are some basic elements which are crosscutting in different forms of strategies. For instance, surveillance is a basic preparedness concept. It is vital in helping to collect any information that may be used in the assessment of any bio-chemical attack (Tucker, 1996). Bioterrorism is dangerous due to the fact that it is not easily detected and it may actually take many lives before it is fully detected (Henderson et al., 2003).
In the United States, the domestic model that is involved in the management of health has a higher response alert. It is a comprehensive system that covers both policy decisions as well as medical response. The United States has a detailed policy framework which helps deal with any terrorist attack. The important end goal of any preparedness program is to ensure that a security solution is achieved.
Different Types of Responders and Their Functions
The United States has carried different levels of training in preparation for any emergency attacks. There are five levels of training that are included in the response system. The first one is the First Responder Level that seeks to cover those people who are likely to be in the scene where the attack has actually occurred. Their training encompasses communication skills and methods as they are required to convey the message of any attack to the authorities.
The next level of training as offered by the Department of Home Securities is the Level of Operations. The people at this level are normally policemen and firemen. In case of a break out, these people are the first responders. For instance, the ambulance and firemen may be involved in the first picking of a suspected patient after an outbreak. The level of training is mainly defense type. It seeks to stop the emergency and ensure the safety of those who have not been affected.
There are also technicians who take part in handling the hazardous materials. Among these people one may indicate medical practitioners who take a scientific approach to study further ways of preventing the anthrax infection. There response is more sophisticated as it takes a curative and preventive approach. They work hand in hand with the specialists who handle the studies. Health practitioners and the emergency medical personnel help in offering specialized and technical help. They participate in the treatment as well as clinical research.
Mailmen are the latest inclusion in the preparations against anthrax and other biologically related attacks. The role to be played by the mailmen during an emergency shall cover timely delivery of antibiotics to deal with the anthrax.
The firemen are also responders in the cases of emergency. They normally help in evacuation of the anthrax victims. While carrying out their rescue mission, they need to protect themselves from exposure. This is a health hazard. During the process of preparing the United States has ensured that the firemen have special kits which protect them from bioterrorism exposure (Grais et al., 2003).
Steps to increase preparedness
Laboratory expansion is also another way through which preparedness enhanced. The Centre for Disease Controls has energized researches. Apart from that, there is a partnership between the center and other health facilities which strengthens the research and prevention of biochemical attacks.
Collective policy and decision making are also important steps which the country has taken in order to ensure that different categories of responders are involved in emergency cases (Tucker, 1996).
Proper communication channels have been set in order to ensure a quick response. One of the challenges that faced the rapidness of the response was the lack of proper communication channel. This can be attributed to the fact that the attack was not foreseeable as at that time.
A partnership between the Center for Disease Control and other health institution is a major step towards the preparation. The partnership extends to both public and private hospitals and medical centers.
Preparedness as a strategic Concept
Preparedness refers to the precautions that are taken in order to avert any disastrous repercussions. It entails being alert as well as having both preventive and curative measures. Preparedness also means being alert and ready to respond to any act that may necessitate such action. The main elements of preparedness involve three main facets. These are training, prevention and finally the healing from the act process. All these require different machineries to be employed and are effective in their different capacity.
Training is important in making sure that there is a constant supply of competent human resource that are able to spring into action whenever such an emergency calls them to. In the United States, this is done at different levels. There are different schools that train health practitioners. Apart from that there is also enough investment in research in order to have an apt knowledge of the agents of bioterrorism. Apart from the health practitioners there is also training on how to handle different emergencies. Under the umbrella of disaster management, there is training on how to handle catastrophe that may occur unexpectedly.
Prevention is another aspect of preparedness. This is the core intention of being prepared. This stems from the fact that prevention shall not only reduce the effects but also save the cost that would have been used to deal if the event was to occur. For prevention to be effective all sections of responders must be prepared. This is because the interdependence between these different sections is important.
The need for preparedness
United States has been a victim of terror attacks on several occasions. This shows that the United States is vulnerable. It is therefore important that steps are taken to ensure that there is preparedness in case of any attack. The attacks have included both bomb attacks as well as biological based attacks. The vulnerability is illustrated through attacks that have been made earlier before. Some of the memorable terrorist attacks include the September 11th bomb attack by the Al-Qaeda. There was an anthrax attack in the year 2001. This vulnerability is one of the main reasons that call for preparedness of the United States as a country.
While the intelligence systems have been strengthened to curb the bomb attacks, there is also need to fully understand how bioterrorism actually takes place. This is one of the core functions that Center for Disease Control carries out. Preparedness is important because it gives a country psychological peace (Grais et al., 2003). This stability is important in the economic growth of any nation.
Furthermore, preparedness is an avenue for research which helps in understanding the physiological processes that are associated with the bioterrorism agents. Preparedness is not only important in responding to emergencies but also important in the development of research and medicine.
Expected Goals of Preparedness
This part of the research seeks to elucidate briefly on the expected end goals of preparedness.
It is expected that if there is proper preparedness within the United States Health system more benefits shall be ripped apart from being alert in case of any attack. In summary, the following positive results shall be attained if the United States health system is prepared;
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U.S. public health agencies as well as other healthcare providers shall have the capacity to mitigate illness and any injuries that have resulted from any acts of biological or chemical terrorism. Mitigation is a very important aspect of preparedness as it reduces the negative impacts which would otherwise bring forth fatalities.
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Through constant training there shall develop a team of efficient healthcare and public health workers shall be available throughout the country. This is important as the skills shall be used in the emergency response in case of an attack. Lack of properly trained personnel can slow down the response.
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There shall develop a comprehensive and efficient communication system. This shall be in place in case of any terrorism-related activities. Rapid response requires rapid linking of different state agencies. With proper communication technology, this shall be achieved. Consequently, the rapidness in responding to emergence shall also increase.
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Preparedness also leads to steady development for the nation. This is because there shall be funds and means ready for acting on any emergency. In the absence of such preparedness, a country is forced to use some other funds which had been set for another development project.
Levels of preparedness adopted by the CDCs
United States as a country has made adequate efforts to be alert in case of any bioterrorist attack. Among its preparations is the establishment of the Centre for Disease Control.
The main strategies adopted by the CDCs can be discussed in five main topics. These are:
Preparedness and prevention
The process of diagnosing and mitigating injuries that arise out of biochemical attacks is normally quite complex and requires a high level of expertise. The CDCs will help in addressing this. They shall create a means by which the diagnosis shall be done. Furthermore, these centers shall provide public health guidelines which shall help to support the activities which seek to develop the level of preparedness of the nation. These include facilities for self assessment as well as those performance standards.
The detection and surveillance strategies
Early detection is the best way to prepare for any bioterrorist attack. This is because the detection gives the health officer involved a clue on how to deal with it. Since bioterrorism is not dealt with using guns and bullets, vaccines and early treatment are important. In order to be able to have any early detection, there is the need to always have surveillance strategies. It is through these surveillance strategies that the detection will be discovered.
It is for this reason that the CDCs will have to integrate surveillance for any cases of injuries, diseases or anything unusual that is linked to a bioterrorist attack. The surveillance shall extend to monitoring the other nations that have these biological weapons. The CDCs will be in the front line and form partnerships with medical experts in different hospital and specifically the emergency departments (CDC Strategic Working Group, 2000). This is because in case of a bioterrorism attack, the emergency sections of the hospitals are likely to get many cases of casualties.
Diagnosis and understanding of the agents of bioterrorism
Extensive research is important in order to understand the agent of bioterrorism. There is need to understand the physiology of different toxins and micro-organisms that can be used as bioterrorism weapons (Grais et al., 2003). To address this, the CDCs, together with their partners shall develop multi-level laboratories which shall be bases for response in case of an attack or an alarm for one. These laboratories shall be distributed throughout the nation. This is in order to facilitate rapid response whenever the need arises. There shall also be a great use of modern technology. For the laboratories, the strategy that the CDCs employ is known as RRAT (Rapid Response and Advanced Technology.)
Rapid response mechanisms
A comprehensive rapid response method does not deal with the problem alone but rather seeks to uncover what actually caused the problem in the first place. In this context, a rapid response shall not only deal with the victims of the bioterrorism attack but shall also determine the cause of the attack. Again, in order to achieve this, different sections of the government should come together and brainstorm on the way forward. This stresses on the fact that while it is the public health jurisdiction to deal with matters of health, there is a need for cooperation in order to achieve faster response.
As part of the response the CDCs are to conduct epidemiological investigations and also try to quickly find the prevention mechanism. The CDCs will work together with different local health authorities. This is important as it will give them an avenue to utilize their resources towards researching into any strange disease that is suspected to have arisen from bioterrorism.
Communication
Coordination is important in responding to any bioterrorist attack. Proper coordination can only be achieved with proper communication (Pesik et al., 2001). In the United States therefore, the mitigation of the consequences and the likelihood of an attack shall be dependent on the coordinated activities of the properly trained medical practitioners as well as the public health authorities. Any unnecessary bureaucracy shall impede the rapidness of the response that is to be adopted.
Communication is also important in warning the public on any bioterrorist activity that has occurred. Through the media, the public are made aware of any government plans to mitigate the consequences of the attack. For instance, the government may use radio stations and televisions to warn the public of areas that have been hit by the attack. Warning people is the first step towards reducing the number of casualties. Communication between the different government units shall also make it easier to respond to the calamity (Macintyre, 2000). Communication should be properly maintained from the political wing to the medical practitioners and finally the enforcement machinery.
Bio Terrorism
While terrorism is a common incident in the world, bio terrorism is a different form of terrorism. It is not as common as it involves a high level of biological technology. A bioterrorism can be defined as the act of deliberately introducing biological hazards into a territory of your enemy for the purposes of causing deaths and medical injury. Biological agents or hazards that can be introduced include toxins, bacteria or even viruses. Terrorists relying on these forms of terror normally seek to use agents that easily cause diseases and are also easily transmitted. Biological hazards that are used normally cause alteration in the body functioning.
This later develops into diseases and makes a nation vulnerable. Another reason why it is very serious is the fact that it can be transmitted in many forms and in different ways. For instance, a bioterrorist attack can be made through water, air and sometimes in food particles (Grais et al., 2003). This makes it hard for the recipient country to be fully prepared and easier for the terrorists to achieve their goal. Some examples of biological hazards that have been used in bioterrorism include the smallpox virus, anthrax and many others (Meselson, 1994).
Bioterrorism is also serious as it does not aim to harm a specific group of people. In case of an attack, it normally sweeps everyone who comes into contact with that bioterrorism agent. Military wings of different nations have appreciated the fact that biological hazards are indeed very powerful weapons. Bioterrorism agents like viruses are hard to tackle because they normally mutate into different forms in order to survive. As a weapon, bioterrorism is thought to be cheaper and require less effort to be implemented.
Bioterrorism also brings along panic in the nation leaving citizens to be scared. This makes the authorities be distracted and be vulnerable to other forms of attacks (Treat, 2001). In this case, the damage that is caused is psychological damage. Sometimes bioterrorism does not aim at harming any humans but just affect the economic balance of a certain nation. A good example of this, can be illustrated by the injection of agents causing foot and mouth disease. This happened in the United Kingdom in 2007. In this case, the attack destabilizes the economy. Terrorists normally aim at causing insecurity in a certain territory. Through these attacks they also distort the economy of their victims and negatively impact on the growth of the same.
Assessing the Level of the US Preparedness
The main question in this research is to assess the level of preparedness in the public health sector. In carrying out this assessment, the first parameter to be considered is whether there is a plan that is in place which shall counter any attack that is biological or biochemical. In the United States, the Centers for Disease Control exist to deal with such diseases. In other words, there are preparations and precautions that should be carried out in case such bioterrorist related injuries are detected. The Center for Disease Control also offers surveillance for any of such diseases.
Cooperation between the public health departments and the hospitals (both public and private) is vital for preparedness. One tool that may be used to establish whether there is effective response is checking whether there are any mutual aid agreements which provide for services that would encourage and promote rapid response. These agreements that allow for the sharing of resources and providing services that are related (Oriole, 1999). In the United States, about 85 percent of the hospitals that exist in the United States have made agreements for disaster management and emergency response (Keim & Kaffmann, 1999).
Another specific method of checking whether there is enough preparedness is to assess whether a health department in a hospital has made adequate sufficient plans that aim at dealing with such attacks. The Standard Operating Procedure that is in place and is dedicated to addressing any biological or biochemical related incident. This has been considered under the United States public health. There are different methods and ways that hospitals have to deal with such incidents. The expertise and contribution provided by the Centers for Disease Control cannot be ignored (Keim & Kaffmann, 1999). The media also play an important and informative role in the prevention of the consequences of these attacks.
The next factor that is to be considered is to determine the level of integration that exists between the existing public health departments and the other emergency responders. Other responders include other hospitals, the police, the firemen and many more (Keim & Kaffmann, 1999). The interconnection between these organs is highly valuable in case of a bioterrorist attack.
Recommendations for further preparedness
Increase communication between different sectors in the preparation and anticipation of the emergencies. The chain of command should have less hassle and also be clear so that in times of emergency accountability is also maintained (Tucker, 1996).
Increase the intelligence surveillance together with the health surveillance. This important as it allows a country to know any enemy that would want to attack the United States.
Another recommendation is to include the preparedness strategies whenever policy frameworks are being created. If these strategies are considered at an earlier level, then implementing them becomes easier.
The need to discuss Bio-terrorism on an international platform is highly recommended. This is because it is a trans-national threat and their effects are also felt by any neighboring country. It is therefore thus mutually dependent. In order to enhance security in case of such a situation there is a need for developing mutual trust and confidence on an international plane.
The need to integrate bioterrorism threat into political agenda is also important. The issue of bioterrorism attack is normally linked with politics. Therefore a need to develop a good political framework and policy dealing with this threat is an idea whose time has come. A good way to do this may be through creating a verification procedure that would implement the Biological Weapons Convention. Bioterrorism is an international threat and this calls for international cooperation.
Countries should come together and form a pact on the regulation of the use of biochemical hazards. A policy and legal framework to deal with this is important as it will bind the different countries which are in the pact.
In implementing such a convention, the countries involved may decide to share information on any of the biological activities. Again, this would depend on the level of trust between the different countries. Mutual trust and confidence plays a very important role in the international relations and peace. Without it, there shall be continued mistrust and out of this mistrust countries shall continue to spend a lot of money investing in weapons. Biological weapons are part of the weapons.
In order to be properly prepared, the need for cooperation between public health officers and the enforcement machineries should emphasized. Working hand in hand, makes communication easier and therefore makes the preparedness be highly effective. The most important thing while these different state agencies are working together is proper and prompts communication. This creates and avails the needed mechanisms in order to execute a rapid response reaction to an attack. Furthermore, there is need to have a synchronized policy statement from the different sections of the responders (Henderson et al., 2003 p. 1410).
Conclusion
Bioterrorism is a great threat to America. The vulnerability of the United State is evidenced by the fact that such attacks have been made before. This calls for proper preparations in order to be fully equipped in repelling and countering such attacks. While bioterrorism is affecting the health of the citizens of the attacked country, preparedness is not done by the health officers alone. The cooperation of other authorities plays a very important role in ensuring that this is achieved.
Coordination is the key to a rapid response. Therefore communication is equally important. Communication seeks to offer a channel for proper coordination and eventually a response that is effective. In summing up this report, the United State needs to improve on the interconnectedness of the health faculty with the enforcement faculty in order to be fully prepared. From the analysis of the above, United States is prepared in case another attack occurs.
References
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